Professional Documents
Culture Documents
Relative Hyperplasia
o Shape and location correspond to a source of irritation
o Limited growth potential
o One of more tissues may be involved (FEP fibrous/epithelial/immune)
Approach to treatment
Eliminate the source of irritation
Monitor/Biopsy
o Confirm suspicion
Remove
o Restore normal tissue contours
Developmental Malformation (Hamartoma)
o Excessive amount of a tissue normally present in the area
o Growth corresponds with skeletal growth
o Tissue is of normal histologic appearance
o Examples
Osseous (Osteochondroma, Odontoma)
Soft tissue (Hemangioma)
Neoplasm
o Clonal proliferation of cells that have a growth advantage over neightbouring
cells
Benign Neoplasm
o Expansile growth
Displace and compress
o Well-differentiated cells
o Generally name the tumors based on the tissue it originates from (i.e.
papilloma = epithelial)
Malignant Neoplasm
o Invasive growth; potential to metastasize
o Effaces normal tissue architecture
o Spectrum of differentiation and cytological atypia
Papilloma
- Exophytic (entire lesion projects above surface)
- Papillary lesion (epithelial origin)
- <1cm diameter
- Well demarcated
- Histologically
o Verify that they ARE exophytic
o Projects can be stubby
o Normal maturation of the epithelium
Verruca Vulgaris (low-risk HPV)
- Sessile, with convergent rete ridges
- More common on skin (but lips and mouth are not uncommon)
- Hyperkeratotic, sessile
- HPV has close relationship with SSE (basal layer) but the upper levels harbor
assembled virus
- Viral cytopathic effect
o Koilocytes (cells containing viral particles)
Pyogenic Granuloma
- VERY vascular and quite edematous (and erythematous)
o Changes size quickly
- Exuberant proliferation of granulation tissue
- Over-reaction to a small irritation
- Lips/Tongue/Buccal mucosa
Peripheral Ossifiyng Fibroma
- Reactive
- Not a lot of bone/calcification
- ONLY shows up on the gingiva
o Cells need to come from the periostium or periodontal ligaments
Peripheral Giant Cell Granuloma
- Reactive
- Purple in colour (possibly because of the hemosiderin)
- Proliferation of mononuclear cells and multinucleated giant cells in stroma with
extravasated blood and hemosiderin
Fibromatosis
- Painless slowly enlarging mass on the lingual aspect of the mandible associated with
the destruction of the lingual cortex
- Interlacing bundles of fibroblasts and collagen; infiltrates into adjacent tissues
o Aggressive but does not metastasize
o Wide surgical excision +/- XRT
Myxoid Lesions of Soft Tissues Oral Focal Mucinosis
- Tumors of myxoid tissue Fibroblasts are making ground substance as opposed to
collagen
- Conservative excision is the treatment
Lipoma
- Benign tumor of fat cells
- Yellow in colour
Granular Cell Tumor
- Asymptomatic nodule on the dorsum of tongue
- Large cells with eosinophilic granular cytoplasm and a small central nucleus
- Pseudoepitheliomatous hyperplasia of the overlying epithelium (should be limited to
the areas where there are granular cells)
- S100+
- Not encapsulated
- Indistinct borders of the lesion
Congenital Epulis
- Benign lesion of neonates
- Anterior maxilla (generally)
- More common in female infants (9:1)
- Can be QUITE large
- FULL of granular cells
o Does NOT show pseudoepitheliomatous hyperplasia
o S100 ve
Benign Vascular Proliferations
- Red to purple lesions that may be flat or raised, not well circumscribed
Cytokerati
n
-
Vimentin
SMA
Desmin
S100
+
+
Antoni A compact bundles of spindle cells, often with palisaded nuclei and
Verocay bodies
Neurofibromas
o Perineural fibroblasts +/- schwanna cells
o Well circumscribed, unencapsulated
o Bucles of spindle ells with wavy nuclei
o Mucoid stroma
o Nerve axons can be shown by silver stains
o Some of the cells are S-100 positive
Look for caf-au-lait spots
R/O neurofibromatosis
o